I'm delighted with my 45-minute erections – but why are my orgasms such a letdown?
Certain medications – whether prescription or over-the-counter – can change the nature of one's orgasm, so consider whether the culprit could be in your medicine cabinet. If this is a possibility, you should consult with the prescribing physician to find out if there might be an alternative. Another element to investigate is whether your hormones might have something to do with it. For example, you might ask a doctor to look at your testosterone levels. Strong orgasms are fuelled partly by sex hormones such as testosterone, and an insufficiency could lead to the symptoms you are experiencing. Finally, I can tell that you are proud of your sexual prowess, but it might be a good idea to relax a bit on the expectations you set for yourself. A person usually has a better orgasm when they are able to let go of performance pressure. Try to focus simply on pleasure.
Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.
If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don't send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.
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Sky News
2 hours ago
- Sky News
Ozempic to Mounjaro - what are the weight loss injections and what were they designed to do?
Drugs designed to treat diabetes and repurposed as miracle diet aids have taken over TikTok - and Hollywood. The weight loss caused by these weekly injectables is rapid and previously unattainable, people boast, showing off newly svelte bodies. But what are these drugs, how do they work - and what were they originally designed to do? Ozempic, Wegovy, Mounjaro - what are they? Let's start with the most well-known of the trio: Ozempic. Ozempic blew up in 2022 - if media reports from the US were to be believed, every pound dropped in LA was probably thanks to the "miracle" injectable drug. What started as the preserve of A-listers and the Hollywood elite quickly grew in popularity. The drug's generic name is semaglutide. This is the same as Wegovy, which has been licensed as a weight loss drug in the UK and is now available on the NHS. Wegovy has a slightly higher dosage and is designed for weight loss, while Ozempic's primary purpose was as a diabetes treatment (more on that later). Mounjaro - also known by its generic name tirzepatide - is the newer kid on the block. Like Ozempic and Wegovy, it suppresses the appetite and lengthens the amount of time food stays in the stomach, leading to weight loss - at least for as long as you carry on taking it. In 2022, the US Food and Drink Administration (FDA) fast-tracked approval of the drug to treat obesity after a study showed it helped people lose more than 20% of their bodyweight. Mounjaro was supposed to be available through GP surgeries and other community services in the UK from 23 June. But at the start of August, Sky News research revealed only eight of 42 NHS Integrated Care Boards (ICBs) in England had started providing treatment to patients, and many of the rest unable to guarantee when it would be available. 3:31 From diabetes drug to diet pill Ozempic and Mounjaro were both developed as treatments for type 2 diabetes. The drugs, which come as weekly injections, lower blood sugar by increasing insulin production when your blood sugar is rising and helping prevent your liver making and releasing too much sugar. So how do they cause weight loss? Both semaglutide and tirzepatide work by mimicking the hormone, GLP-1 (glucagon-like peptide one), to manage hunger and slow down digestion. Tirzepatide - Mounjaro - is a dual-acting drug and also mimics the hormone GIP (glucose-dependent insulinotropic polypeptide). In terms of weight loss, in clinical trials people lost up to 20% of their body weight on tirzepatide and 15% on semaglutide. Researchers have also found the weight loss jabs could reduce the risk of heart attacks, strokes or heart failure in obese people regardless of the amount of weight they lose. They sound like miracle drugs for people wanting to lose weight - what's the catch? There are a few downsides. First off, the listed side effects: nausea, vomiting and diarrhoea, bad enough for about 5% of people in the semaglutide trial to stop taking it and 6-7% in the tirzepatide trial. People in the semaglutide trial also experienced problems with gallstones. The drugs also carry serious risks including kidney failure, pancreatitis and thyroid cancer. Another downside has been dubbed "Ozempic face". Facial ageing is a side effect of sudden weight loss as people find the skin on their face sagging where once it was plump. The drugs also only work for as long as you carry on taking them, and people have reported gaining back all the weight they lost after stopping the drug - either out of choice or because of a supply shortage. In August, the National Institute for Health and Care Excellence (NICE) - the body that provides guidance on the use of new drugs - said that people coming off the drugs should be offered "structured advice and follow-up support" to help prevent weight gain. This includes being monitored by the NHS for at least a year after completing treatment and support to help build "long-term behavioural habits, use self-monitoring tools, and draw on wider support - from online communities to family-led interventions and local activities". Shortages for diabetics Perhaps a bigger conversation than side effects for individuals is around the impact on people who rely on these treatments, now they've exploded in popularity as a weight loss quick-fix. While intended for diabetics, Ozempic and Mounjaro are prescribed "off-label" in the US to people wanting to shed weight. The drugs faced widespread shortage last year, with reports of diabetics having to drive from pharmacy to pharmacy in search of stock because of the high demand. Links to cancer prevention Research has suggested weight loss jabs, officially GLP-1 receptor agonists, could almost halve the risk of obesity-related cancers. The study, published in the journal eClinicalMedicine, was presented at the European Congress on Obesity in Malaga. It found that there were similar rates of obesity -related cancer among patients treated with the injections and those given weight loss, or bariatric, surgery. Dr Yael Wolff Sagy, the study's co-lead author from Clalit Health Services in Tel-Aviv, Israel, said a "direct effect" of the injections was that they were found "to be 41% more effective at preventing obesity-related cancer". "We do not yet fully understand how GLP-1s work," she said. "But this study adds to the growing evidence showing that weight loss alone cannot completely account for the metabolic, anti-cancer, and many other benefits that these medications provide." Co-lead Professor Dror Dicker, from Hasharon Hospital, Rabin Medical Centre in Israel, suggested the protective effects of the drugs "likely arise from multiple mechanisms, including reducing inflammation". He added further research was needed "to make sure that these drugs do not increase the risk for non-obesity-related cancers". Being overweight or obese is the second biggest cause of cancer in the UK, causing more than one in 20 cancer cases, according to the NHS. Are they available in the UK? An estimated 1.5 million people are taking weight loss jabs in the UK, the vast majority of whom pay for them privately. Ozempic is available in the UK for type 2 diabetes patients with a prescription. Wegovy and Mounjaro is available to NHS patients, but only through specialist weight management services. Over the next three years, around 240,000 people with the "greatest need" are expected to receive Mounjaro through the NHS. However, Sky News research into Wegovy and Mounjaro shows delays in the rollout of both weight loss jabs.
The Guardian
3 hours ago
- The Guardian
Covid cases rising in US as officials plan to restrict booster vaccines
Covid is on the rise again in the US, as children begin returning to school and as officials plan to restrict booster shots. While cases are increasing less quickly than at the start of other surges, it is too soon to tell how big the current late-summer wave could get – and with highly varied immune responses from prior infections and vaccinations, it is difficult to know how severe illness could be, experts said. The risks of a wave are compounded by new vaccine restrictions from the Trump administration. 'If you're vaccinated against Covid-19, you're less likely to get infected,' said Andrew Pekosz, a virologist at Johns Hopkins University. 'But we haven't gotten a lot of people vaccinated for the past few years, and with the current recommendations changing, it's even less likely.' Future waves could become more severe as vaccination lags and immunity drops, Pekosz said. Several key measurements – including wastewater data, test positivity and emergency room visits – indicate a new rise in infections. In the past, Covid has surged about twice a year, usually in the summer and the winter. But the pattern can change, as it does with other respiratory viruses – with late or early starts to the season and curveballs like double peaks. 'Each year has been different, so in some ways, this is more of the same,' said Sam Scarpino, a professor of health sciences at Northeastern University. Cases are increasing or probably increasing in 26 US states, especially in the south and midwest, according to the US Centers for Disease Control and Prevention (CDC). 'In the snapshot that we're seeing right now, increases are happening at a relatively low rate, and that would indicate that we probably aren't going to peak at a very high level. But again, this is early in this summer surge, so we really have to keep monitoring the data and paying attention to what it's telling us,' Pekosz said. The variants currently spreading around the globe have known immune-evasion properties, Scarpino said. 'You can look at the rise that we're seeing, the fact that we know it's an immune-escape variant, and I think we can be pretty confident that there's some kind of wave coming,' Scarpino said. 'Whether it's going to be large or small, I don't think we could really say one way or the other.' But 'the vaccines are still providing some protection,' he said. 'It's never too late to get the booster.' Yet officials softened the recommendation for children on Covid vaccines, and they removed the suggestion entirely for pregnant people, despite the clear benefits of the shot in reducing the risk of severe illness and death during pregnancy. A new, more effective Covid shot from Moderna and the Covid shot from Novavax were approved only for people over 65 or people over the age of 12 with health conditions. The independent advisers to the US Food and Drug Administration (FDA) recommended that vaccine manufacturers once again update booster shots this fall to a more recent variant. Covid boosters are usually recommended for all adults. But this fall, the boosters may be limited to older people and those with health conditions, FDA officials wrote in May. 'So it's a big question mark, going into the fall, is who it's going to be approved for,' Scarpino said. 'If it's not approved, can you still pay out of pocket for it? How much is it going to cost? And then are there going to be supply chain issues?' Health officials have also called for placebo trials for the boosters to judge their benefit to people without pre-existing conditions – but such trials would be unethical and extremely difficult to conduct, experts say. 'Clearly, the guidelines right now are focused on the populations that are more prone to have severe disease and severe outcomes. It's always been good to vaccinate that population,' Pekosz said. But the Trump administration is moving away from the approach of immunizing broad swaths of the population – especially those most likely to get and pass the virus on, like children, he said. 'If you vaccinate broadly, you can reduce the spread of Covid-19 in the population,' Pekosz said. 'The benefit, to me, is very clearly on the side of getting vaccinated.' Some of the pre-existing conditions proposed by FDA officials include asthma, diabetes, depression and physical inactivity. According to that list, 'basically everybody's eligible for one of the vaccines,' Scarpino said. And doctors, including pediatricians, may also prescribe vaccines for off-label use. Yet the more restrictions are placed on vaccination, the harder it is to reach even the people who need it most, Pekosz noted. Antivirals like Paxlovid could also see wider use, the experts said. 'We shouldn't forget about the antivirals,' Pekosz said. 'Those don't seem to be the target of more restrictive use by the CDC or the FDA, so those will be available for people if they do get infected.' A program to make Paxlovid more affordable to those who need it is slated to end in December. 'The benefits of antiviral treatment are very clear with respect to hospitalization and mortality decreases,' Pekosz said. Paxlovid is still highly effective against current variants, Scarpino said. 'There's a whole bunch of good reasons to get it.' Rates of hospitalizations and deaths in recent waves have dropped among adults compared with earlier Covid waves, but the virus remains deadly. An estimated 35,000 to 54,000 people in the US have died of Covid since October. Children continue to see hospitalizations rates from Covid similar to previous years. Covid cases can be less severe because of immunity – from prior infection or from vaccination. 'It's not so much that the virus has become less dangerous, it's that we have immunity, so we fight off the virus more efficiently than we did early in the pandemic,' Pekosz said. That's why vaccinations remain a key part of controlling Covid, he said. Without boosters, people become more susceptible to severe illness and death. About 23% of adults had received updated Covid boosters as of April. About 5.6% of children aged six months to four years are vaccinated against Covid, and about 15% of children aged five to 17 are vaccinated, according to the CDC. 'Children's cases are always surging, because children don't have much immunity to Covid,' Pekosz said. 'Covid cases are really occurring in children at a very high level right now. It's not nearly as dangerous in children as it is in adults, but it still causes a lot of hospitalizations in children.' Hospitalizations and deaths are not the only ways to measure the damage and disruption wrought by Covid. While the Trump administration has not released updated data on long Covid, an estimated 5.3% of all adults in the US said they were currently experiencing long-term Covid symptoms as of September. Even in times of lower transmission, Covid still circulates, with 149 deaths in the week ending 28 June, the last week for which the CDC shares full mortality data. 'It's still a little surprising that it's around all year,' said Pekosz. During lull times, 'we're not seeing it disappear completely, like we do with other respiratory viruses.' When it comes to keeping rates of Covid low, 'it's all the same stuff we usually go over,' Pekosz said – getting vaccinated, taking precautions like masking and using air purifiers, and staying home if you're sick. 'But it's just a very different environment these days. When the government doesn't use the science to drive their decision making, you can see the confusion that it puts into the general public.'
The Independent
3 hours ago
- The Independent
Photos of Mexican ranchers struggling to adapt as screwworm ravages their cattle exports to the US
The U.S. has suspended live cattle imports from Mexico due to concerns about the New World Screwworm, a flesh-eating parasite found in southern Mexico. This suspension has severely impacted ranchers like Martín Ibarra Vargas in Sonora, who are already struggling with drought. The U.S. Department of Agriculture calls the screwworm a 'devastating pest' and is taking measures to prevent its spread.
